Healthcare Resource Utilization Associated with Burns and Necrotizing Fasciitis: A Single-Center Comparative Analysis.

Abstract

Necrotizing fasciitis (NF) patients are increasingly managed in burn units. Although treated similarly to burns, the healthcare resource utilization (HRU) in NF appears to be greater. Accurate knowledge of the HRU is important to better allocate resources and to compare outcomes between units. The goal of this study is to provide better understanding of the HRU for NF compared with burns. A retrospective chart review of patients ≥18 years admitted to two regional tertiary referral centers with either NF or burns requiring surgery. The authors examined age, sex, %TBSA, geographic region, anatomical location, length of stay (LOS) in hospital, LOS in intensive care unit, number of operative procedures, number of packed red blood cells transfused, amputation, death, and use of free tissue transfer or skin graft. There were 210 NF and 209 burn patients. The NF cohort had a smaller TBSA (3.3 vs 10.0%), longer LOS (20 vs 14 days), and consequently a longer LOS/%TBSA (6.0 vs 1.5 days). This difference persisted after adjusting for age. More of the NF cohort (44.8%) spent ≥1 day in the intensive care unit. The NF cohort also had more procedures (median 2 vs 1), required blood (46.2 vs 16.7%), died in hospital (13.3 vs 4.3%), had an amputation (12.4 vs 4.8%), or required free tissue transfer (7.6 vs 2.9%). This study shows that NF requires substantially more HRU compared with burns. This information is important in recognizing the impact of these patients on burn units and planning for allocation of appropriate resources.